Finding Psychopathy in Unexpected Places

What do serial murderers, hardened criminals, and punitive dictators have in common with ruthless business executives who profit from the misfortunes of failed investments or downsizing? In his latest book, "The Psychopath Test," journalist Jon Ronson convincingly presents the argument that many share qualities that produce a high score on the Hare Psychopathy Checklist-Revised (PCL-R) including these core traits: lack of remorse for destructive acts, inability to experience empathy, impulsiveness, sexual promiscuity, and manipulativeness. At the same time, however, Ronson raises important and timely questions about the psychiatric enterprise and the possible over-diagnosis of ordinary human traits.

The PCL-R is a research instrument with stellar psychometric qualities. Robert Hare, the Canadian researcher who developed the scale, was one of the first psychologists to draw attention to the core personality traits of what, in the past, was referred to as "sociopathy." Now listed as a diagnosis in the American Psychiatric Association's reference manual, the DSM-IV-TR, it is called "Antisocial Personality Disorder." Having one or two of the qualities that give a person a high score on the PCL-R doesn't mean that you're a psychopath, and it's possible to accumulate a high score without ever having committed acts that have seriously harmed anyone. As with any psychologist instrument, there is a certain amount of error involved.

Unlike typical self-report rating scales the PCL-R, to be valid, must be given by a person trained in its administration and scoring. Hare travels around the world giving training seminars (at a fee) which allows even non-psychologists to become certified. The tool is clearly most valuable to people who work in the criminal justice system, but if you believe Ronson, it might be of use for Human Resource managers or financial analysts.

Ronson's explorations through the world of psychopathy research also led him to insights about flaws in the diagnostic systems that psychiatry uses to decide who's a psychopath and who's not. I think the most compelling material in the book aside from the book's main thesis is the analysis Ronson provides about the DSM itself. In a previous post, I pointed out the problems in the DSM5's proposed changes in diagnostic criteria for Alzheimer's disease. Ronson takes on the autism diagnosis on similar grounds- are diagnoses expanded upon not for scientific or even clinical reasons but in order to sell more drugs?

Just as we are over-medicating older adults with dementia (who may or may not have Alzheimer's disease), are we over-medicating children based on the expanded diagnoses of not only autism but bipolar disorder? Fellow Psychology Today blogger Allen Frances, M.D., expresses his doubts, in an interview with Ronson, about whether the diagnostic pendulum has swung too far in the direction of creating and expanding diagnoses to apply to behaviors within the range of "normality."

These arguments are not meant to imply that we should discount the impact on people's lives of the symptoms associated with psychological disorders. Nor should we discount the true suffering that can be caused by people high in psychopathy who commit murder, felonies, or con jobs. The point is that over-medication on the basis of over-diagnosis can itself create symptoms that only make the individual's life more challenging on a daily basis.

Returning to the issue of psychopathy, it's doubtful that a medication will be found to "cure" this collection of personality traits. Yes, there is research suggesting that psychopaths have smaller amygdalas than non-psychopaths. This is important because the amygdala plays a role in emotional learning. If people don't learn to fear the consequences of their negative (if not criminal) behaviors, then what's to stop them from committing those behaviors?

However, can the behavior of anyone, including someone with a presumed brain anomaly, be reduced to the size of a brain structure? Is it possible that there are loads of people with small amygdalas who don't become murderers because their early environments made up for whatever neurological deficit they were born with? Or did their amygdalas develop abnormally because of harsh early lives? Even experiments on lab animals can never answer these questions. Though one could imagine a homicidal Mickey Mouse, since mice don't have prefrontal cortexes that control their ability to plan, reason, and think abstractly, it's pretty tough to generalize from controlled experiments involving non-human species.

It's rare to read a popular book about psychology by non-psychologists that causes me to want to stand up and cheer. However, with "The Psychopath Test," I found myself more than once not only cheering but laughing out loud. You may not become an expert at sniffing out psychopaths but you'll learn a great deal about the ambiguities and pitfalls of psychiatric diagnoses. Human behavior doesn't neatly fall into the categories of "medical" illnesses. A broken bone is one thing; a broken mind something else entirely.

To sum up, here are the main points from "The Psychopath Test":

1. People high in psychopathy aren't necessarily found in prison. There are plenty of individuals who have psychopathic traits, from the lover who unceremoniously dumped you to the boss who seemed to take pleasure on firing you.

2. Psychopaths are people too. Though Robert Hare regards psychopaths as a "different species," the point that they may have become that way through their early experiences such as abuse or neglect is a valid one.

3. Don't be too quick to jump on the diagnosis bandwagon. The precipitous rise in certain psychiatric diagnoses (autism, childhood bipolar diagnosis, Alzheimer's disease) may say as much about the politics of psychiatry as about its science. Erroneous diagnoses can have disastrous effects.

4. Appreciate the fact that psychological disorders rest on a continuum. Unlike physical illnesses, the disorders that affect the mind can't easily be categorized. Not only do people vary in degree, but what's normal in one culture may be evidence of disorders in other cultures-there are few absolutes in this field.

5. Learn to differentiate good from bad self-rating scales. The PCL-R is a good rating scale that is based on years of solid research. Unlike checklists you find in magazines, those that researcher use must meet rigorous scientific criteria.

The field of abnormal psychology is full of danger zones in which erroneous diagnoses may be too loosely applied or serious diagnoses missed. There's an art and a science to the process. We can only hope that the science of validly determining the true nature of disorders continues to help alleviate the anguish they can cause.

I haven't read the book but I just might, I've seen an interview he gave about the it, very interesting. :)

I spent most of my life oblivious about what sociopaths/psychopaths (or malignant narcissists) were exactly. But events that took place in these last few years of my life led me to delve into the subject.
In the past I was critical of some experts objectifying psychos, referring to them as "things", or something of the type. It seemed like name-calling bordering the unprofessional. But nowadays I'm more empathetic about it, I tend to see this as a psychological defense needed to safeguard one's sanity when dealing with them. Everything I regard as making someone a person doesn't apply to them. And no, I'm not quick to profile them, I think it's a very serious diagnosis, it's very important to be aware of the other dozens of prognosis which might resemble psychopathy in one way or another but are something else. One may not care to be called a psycho if he actually is one(but then he/she isn't affected by much else at all anyway), but if he/she is not, then this is absolutely the worst(I mean it, the worst) label possible. I'd say, something like L'etranger by Camus times ten.

"The field of abnormal psychology is full of danger zones in which erroneous diagnoses may be too loosely applied or serious diagnoses missed."

Really. Too bad the author limited the field of "abnormal" psychology to being one full of danger zones when the entire industry of psychology lacks much in the way of having a healthy perspective. Why, for example are psychologist, social workers, and head shrinks with failed medical degrees so fascinated with those who may possess an anti-social personality disorder? As if that boss no one likes takes pleasure in firing you then they must also be the cliche serial killer next door as well.

If anything the psychological field is full of a lot of things and little of them are beneficial to society which is why I think (and still believe) that psychology has lost its purpose and turned into another profit-for-others-misery enterprise. With all the studies that go on in this field I like to see one done where misdiagnosing has led to real emotional and/or psychological damage of those unfortunate who have gone through such an experience. Shame the psychological field has become and thinks too much on being a business rather than a humanitarian need.

And just how many social workers, psychologist, whatever are anti-social themselves? How many of them enjoy see the suffering of their clients? How many of them self-medicate, engage in promiscuous sex or drive reckless, or get tremendous satisfaction in screwing over their fellow co-worker for a higher clinical position? What a perfect job to be in. To me, that's how a "serious diagnosis" of a client can be misused yet the psychological field rarely holds a mirror up to itself and begins to realize how fucked it all really is.

The thin path between Normal and psycho . Or is it just the everyday crazy person we all have been one time or another . How does one decide . Or do we ., Do we wait, trust instinct or the last run .
The truth of the matter Every psychopathss has walked among us at sometime or another (it seems the individuals with thequintessentiale seem to get caught . In that alone this is a bit unsettling . The others are nomads within society .

Psychopathy, the genetic brain defect in areas of the brain required for am advanced social species. The ticking time bomb responsible for the majority of crimes against people, the balance between criminal act and peaceful coexistent not learning but frustration, the greater the frustration the more violent the outcome, a broken phone charger is enough to the final trigger in a murderous response.
Interesting side note, psychopaths also like getting into psychiatry and psychology as it gives them greater opportunity to manipulate people. Psychopaths will always work to hide and protect their subspecies, they know who they are and they know the harm they cause.

I really don't understand how people believe that there is a spectrum for those who lack a conscience. You either have one or your don't; you can't have "just a little bit of" or "mostly" a conscience.

It is my personal belief that sociopaths/psychopaths (those people/or another species, rather, without a conscience) can be described as the opposite of perfect (if people want a spectrum), with all of the varying degrees of empathy in between. Sociopaths/Psychopaths are not human in regard to how most people think of humanity. When sociopaths/psychopaths are referred to as people who are "losing their humanity", it's quite ironic because they never had it in the first place.

Regarding them being diagnosed, however, it is my understanding that it is not common. What sociopath/psychopath is going to walk into a counseling session anyway? (Unless they have something major to gain and believe - of course - that no one will suspect anything but normalcy of them -- which isn't far off from accurate for an unsuspecting counselor and lover.)

Also, a lot of the literature that one can find on sociopaths/psychopaths make it pretty clear that this is not something of nurture (or rather, lack thereof), but rather nature. How can one lose a conscience?

This is a label that very well may apply to my ex-husband. He was able to manipulate, lie, and steal for years with no one being the wiser. He was arrested for felony bigamy and slithered his way right through the system. Throughout the divorce, he showed no empathy for anyone. It is impossible to diagnose from afar, but if the shoe fits...
http://lessonsfromtheendofamarriage.com